Leonard Zwelling

This is about as sensitive an issue as this blog will ever comment upon.


First, the BW and I are both second-generation Americans (with an asterisk as each of us has one American-born grandparent). What that means is that whatever we have been able to do in our lives directly derived from the courage of our not-so-distant ancestors (our grandparents) to leave Eastern Europe, the pograms, and the persecution for opportunities in the New World. Without them, no positions of responsibility at MD Anderson, no house in Bellaire, and no grandchildren. We owe our grandparents everything. Somehow, they got to America—New York, Baltimore, Pittsburgh, and Zanesville, Ohio.

Second, make no mistake, had our grandparents not made the journey here, we would probably have never been born. The Nazis would have killed our parents if the Russians didn’t do it first.

Third, not only were our grandparents running from something, they were running to something—opportunity. Yes, both our fathers were victims of antisemitic quotas, but eventually, they were able to carve out a middle class life that allowed us both to get great educations and graduate from Duke Medical School.

Fourth, the Zwelling family has been the beneficiaries of the labor of some of the hardest working people we have ever met from countries south of our border. Admittedly, they have all been legal immigrants who have provided our childcare and other household help over the years and as far as I can tell all of them have become American citizens and have grown families who contribute to the GDP and pay taxes. We would never have been able to do what we have done without the help of these people. We will always be grateful.

Finally, it is no great observation that the immigration crisis of 2023 is on our southern border. It is not at the northern border. Canadians are not clamoring to come to America. The countries below the Rio Grande are filled with crime, gangs, drugs, violence, and political instability. These conditions are not all that different from the ones that got our grandparents here from Europe.

Thus, I am very sensitive to the needs of those who wish to come to the United States to make new lives for themselves.


The current immigration system is clearly broken. The United States needs more hard-working people. Service quality and availability is at an all-time low. Surely, many of these service jobs would go to new Americans and could ease the stress of inadequate service in all sectors including in health care. There are a lot of great nurses south of our border. However, the current stress on the border is from those people like my grandparents running from oppression and danger. We must find a way to welcome this valuable resource without over-running the capacity of border cities and now northern sanctuary ones to clothe, house, and feed all these migrants.

It is my belief that the country would be better off allowing these people in (while screening out the criminals, please), making sure they are initially cared for if they have no relatives with which to stay, facilitate their getting green cards, and training them for work and self-sufficiency. As the great Tom Friedman has said, every non-American PhD who graduates from an American university ought to have a green card stapled to his or her diploma. Friedman has just advocated (NYT, May 17) for a high wall and a big gate. I agree with that.

This is a problem that Congress simply cannot continue to ignore and one that the executive branch ought to make priority one. The real solution must rest with the Congress which has avoided its duty since 1986, the time of the last immigration reform.

Unless you are an American Indian, someone in your lineage came here from somewhere else. Building a wall on the southern border is not the answer UNLESS it has a big gate. A facilitated path toward citizenship, job training, and more judges on the border would be the beginning of a solution.

America needs these people. Just look around you. People from elsewhere are everywhere and they make the country richer in every way. Let’s fix this now. It’s in our best interest. It is certainly in mine. And it is essential for academic medicine.

Dr. Zwelling’s new novel, Conflict of Interest: Money Drives Medicine and People Die is available at:,

on amazon if you search using the title and subtitle,


directly from the publisher Dorrance at:

4 thoughts on “Immigration”

  1. Your sentiments match mine.
    With the shortage of doctors, nurses and other healthcare workers, we need a WIDE gate for international immigrants with these skills. We need a quick way to test their competency and give them state licenses so that they can practice their top skills. I have seen surgeons and urologists from abroad who end up working as surgical assistants because state and local licensing groups block them. Competent physicians are required to repeat residencies to be board-certified. Many of them have made major contributions after arriving in America, e.g. Dr Julio Palmaz from Argentina and the coronary artery stent.
    The immigration mess is unfortunately another example of a Federal system that currently is incompetent in solving major issues.
    America is still falling short of electing the BEST.

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